Open NotePad.
Duplicate and place one of layer 10
and the other on layer 11.
Use the clipping mask the same way you did with your papers.
Rotate Notepad around and get it how you like then Merge.
Open up a close up of your tube and duplicate.
Place one on 10 and mirror on 11.

Now open up close up 2.
Place over layer 2 and change blend mode to Luminosity.
Make the eye peak over the top of template.
Erase the bottom then duplicate close up
and flip horizontal.
Make so that you see the eye peaking out of the bottom half.
See tag for exact placement.

Now lets add some elements!

BloodyHeart
Bear1
FenceWithBlood
Ribbon1

Feel free to add more or totally different elements.
Make it personal to you.